FILED 11/02/2017 1:21 PM ARCHIVES DIVISION SECRETARY OF STATE

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OFFICE OF THE SECRETARY OF STATE DENNIS RICHARDSON SECRETARY OF STATE LESLIE CUMMINGS DEPUTY SECRETARY OF STATE TEMPORARY ADMINISTRATIVE ORDER INCLUDING STATEMENT OF NEED & JUSTIFICATION DMAP 46-2017

1 OFFICE OF THE SECRETARY OF STATE DENNIS RICHARDSON SECRETARY OF STATE LESLIE CUMMINGS DEPUTY SECRETARY OF STATE TEMPORARY ADMINISTRATIVE ORDER INCLUDING STATEMENT OF NEED & JUSTIFICATION DMAP CHAPTER 410 OREGON HEALTH AUTHORITY HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS ARCHIVES DIVISION MARY BETH HERKERT DIRECTOR 800 SUMMER STREET NE SALEM, OR FILED 11/02/2017 1:21 PM ARCHIVES DIVISION SECRETARY OF STATE FILING CAPTION: Update Rules Governing Payment for the Medicaid EHR Incentive Program EFFECTIVE DATE: 11/02/2017 THROUGH 04/30/2018 AGENCY APPROVED DATE: 11/02/2017 CONTACT: Stacey Weight s 500 Summer St. NE Salem,OR Filed By: Sandy Cafourek Rules Coordinator NEED FOR THE RULE(S): The Division needs to amend these rules as new federal legislation from the Centers for Medicare and Medicaid Services (CMS) and updates to Oregon s Medicaid State Plan Amendment affects how providers are eligible for the Medicaid EHR Incentive Program. These rules include changes for the 90-day EHR reporting period in The temporary rule is needed as the changes are effective on October 1, JUSTIFICATION OF TEMPORARY FILING: The Authority finds that failure to act promptly will result in serious prejudice to the public interest, the Authority, and recipients of Medicaid benefits. The rule changes became effective on October 1, 2017 and impact providers for program years 2017 and later. There are also minor clarifications to wording throughout the rule. These rules need to be adopted promptly as providers are currently attesting for DOCUMENTS RELIED UPON, AND WHERE THEY ARE AVAILABLE: Federal Register Vol 77 October 23, Federal Register Vol 77 September 4, Federal Register Vol 75 July 28, Federal Register Vol 75 December 29, CMS State Medicaid Director letter SMD # RULES: , AMEND: RULE TITLE: Basis and Purpose RULE SUMMARY: The Division needs to amend these rules as new federal legislation from the Centers for Medicare

2 and Medicaid Services (CMS) and updates to Oregon s Medicaid State Plan Amendment affects how providers are eligible for the Medicaid EHR Incentive Program. These rules include changes for the 90-day EHR reporting period in RULE TEXT: (1) These rules (OAR chapter 410, division 165) govern the Oregon Health Authority (Authority), Health Systems Division (Division), Medicaid Electronic Health Record (EHR) Incentive Program. The Medicaid EHR Incentive Program provides incentive payments consistent with federal law concerning such payments to eligible providers participating in the Medicaid program who adopt, implement, upgrade, or successfully demonstrate meaningful use of certified EHR technology and who are qualified by the program. (2) The Medicaid EHR Incentive Program is implemented pursuant to: (a) The American Reinvestment and Recovery Act of 2009, Pub. L. No , section 4201; (b) The Centers for Medicare and Medicaid Services (CMS) federal regulation 42 CFR Part 495 (2010, 2012, 2014, and 2015) pursuant to the Social Security Act sections 1903(a)(3)(F) and 1903(t); (c) The Division s General Rules program, OAR chapter 410, division 120; (d) The Authority s Provider Rules, OAR chapter 943, division 120. (3) The following retroactive effective dates apply to these rules: (a) For all sections in these rules that refer to pediatric optometrists, the effective date is July 1, 2016; (b) For rule that refers to: (A) CMS federal regulation 42 CFR Part 495 (2016), the effective date is January 1, 2017; (B) CMS federal regulation 42 CFR Part 495 (2017), the effective date is October 1, (c) For all sections in these rules that refer to naturopathic physicians, the effective date is May 2, 2017; (d) For eligible hospitals, except for sections and references in these rules applicable under section (3)(a) or (b) above, the effective date is October 1, 2013, which is also the start date for program year 2014; (e) For eligible professionals, except for sections and references in these rules applicable under section (3)(a) or (b) above, the effective date is January 1, 2014, which is also the start date for program year STATUTORY/OTHER AUTHORITY: ORS STATUTES/OTHER IMPLEMENTED: ORS ,

3 AMEND: RULE TITLE: Meaningful Use RULE SUMMARY: The Division needs to amend these rules as new federal legislation from the Centers for Medicare and Medicaid Services (CMS) and updates to Oregon s Medicaid State Plan Amendment affects how providers are eligible for the Medicaid EHR Incentive Program. These rules include changes for the 90-day EHR reporting period in RULE TEXT: (1) An eligible provider shall demonstrate being a meaningful EHR user as prescribed by 42 CFR (2010, 2012, 2015, and 2016), 42 CFR (2010, 2012, and 2014), 42 CFR (2010, 2012, and 2014), 42 CFR (2015), 42 CFR (2015 and 2016), 42 CFR (2015 and 2016), and 42 CFR (2015 and 2016): (a) For eligible providers demonstrating meaningful use under the program in Stage 1 prior to December 15, 2015, to comply with 42 CFR 495.8, the State of Oregon requires the eligible provider to satisfy the objective Capability to submit electronic data to immunization registries or immunization information systems and actual submission in accordance with applicable law and practice; (b) For eligible hospitals: (A) If CMS deems an eligible hospital to be a meaningful EHR user for the Medicare EHR Incentive Program for a program year, the eligible hospital is automatically deemed to be a meaningful EHR user for the program for the same program year; (B) An eligible hospital deemed to be a meaningful EHR user by CMS for a program year does not have to meet the requirements specified in section (1)(a) for the program for the same program year. (2) As prescribed by 42 CFR (2010, 2012), the following meaningful use EHR reporting periods shall be used by eligible providers that are demonstrating meaningful use to the program for: (a) Program years 2011, 2012, and 2013: (A) Eligible professionals: (i) For the first time, either: (I) Any continuous 90-day period in the calendar year; or (II) The calendar year. (ii) For a subsequent time: the calendar year. (B) Eligible hospitals: (i) For the first time, either: (I) Any continuous 90-day period in the federal fiscal year; or (II) The federal fiscal year. (ii) For a subsequent time, the federal fiscal year. (b) Program year 2014: (A) Eligible professionals, either: (i) Any continuous 90-day period in calendar year 2014; or (ii) Any of the following 3-month periods: (I) January 1, 2014 through March 31, 2014; (II) April 1, 2014 through June 30, 2014; (III) July 1, 2014 through September 30, 2014; or (IV) October 1, 2014 through December 31, (B) Eligible hospitals, either: (i) Any continuous 90-day period in federal fiscal year 2014; or (ii) Any of the following 3-month periods: (I) October 1, 2013 through December 31, 2013; (II) January 1, 2014 through March 31, 2014;

4 (III) April 1, 2014 through June 30, 2014; or (IV) July 1, 2014 through September 30, (3) As prescribed by 42 CFR (2015, 2016), the following meaningful use EHR reporting periods shall be used by eligible providers that are demonstrating meaningful use to the program for: (a) Program year 2015, prior to December 15, 2015: (A) Eligible professionals attesting for the first year, either: (B) Eligible professionals attesting for a subsequent year, the calendar year; (C) Eligible hospitals attesting for the first year, either: (i) Any continuous 90-day period in the federal fiscal year; or (ii) The federal fiscal year. (D) Eligible hospitals attesting for a subsequent year, the federal fiscal year. (b) Program year 2015, on or after December 15, 2015, any continuous 90-day period in the calendar year; (c) Program year 2016 before January 1, 2017: (B) A subsequent year, the calendar year. (d) Program year 2016 after January 1, 2017: (A) Any continuous 90-day period in the calendar year; or (B) The calendar year. (4) As prescribed by 42 CFR (2017), the following meaningful use EHR reporting periods shall be used by eligible providers that are demonstrating meaningful use to the program for: (a) Program year 2017 before October 1, 2017: (B) A subsequent year: (ii) The calendar year for meaningful use objectives; and (iii) A calendar year for the Clinical Quality Measures. (b) Program year 2017 on or after October 1, 2017: (A) Any continuous 90-day period in the calendar year; or (B) The calendar year. (c) Program year 2018: (B) A subsequent year: (ii) The calendar year for meaningful use objectives; and (iii) A calendar year for the Clinical Quality Measures. (d) Program year 2019:

5 (B) A subsequent year, the calendar year. STATUTORY/OTHER AUTHORITY: ORS STATUTES/OTHER IMPLEMENTED: ORS ,

FILED 11/30/2017 9:05 AM ARCHIVES DIVISION SECRETARY OF STATE

FILED 11/30/2017 9:05 AM ARCHIVES DIVISION SECRETARY OF STATE OFFICE OF THE SECRETARY OF STATE DENNIS RICHARDSON SECRETARY OF STATE LESLIE CUMMINGS DEPUTY SECRETARY OF STATE PERMANENT ADMINISTRATIVE ORDER DMV 20-2017 CHAPTER 735 DEPARTMENT OF TRANSPORTATION DRIVER